title: Integration of collaborative medication therapy management in a safety net patient-centered medical home.
abstract: OBJECTIVE
  To describe the integration of collaborative medication therapy management (CMTM) into a safety net patient-centered medical home (PCMH).
  
  
  METHODS
  Federally qualified Health Care for the Homeless clinic in Richmond, VA, from October 2008 to June 2010.
  
  
  METHODS
  A CMTM model was developed by pharmacists, physicians, nurse practitioners, and social workers and integrated with a PCMH. CMTM, as delivered, consisted of (1) medication assessment, (2) development of care plan, and (3) follow-up.
  
  
  METHODS
  CMTM is integrated with the medical and mental health clinics of PCMH in a safety net setting that serves homeless individuals.
  
  
  METHODS
  Number of patients having a CMTM encounter, number and type of medication-related problems identified for a subset of patients in the mental health and medical clinics, pharmacist recommendations, and acceptance rate of pharmacist recommendations.
  
  
  RESULTS
  Since October 2008, 695 patients have had a CMTM encounter. An analysis of 209 patients in the mental health clinic indicated that 425 medication-related problems were identified (2.0/patient). Pharmacists made 452 recommendations to resolve problems, and 384 (85%) pharmacist recommendations were accepted by providers and/or patients. For 40 patients in the medical clinic, 205 medication-related problems were identified (5.1/patient). Pharmacists made 217 recommendations to resolve the problems, and 194 (89%) recommendations were accepted.
  
  
  CONCLUSIONS
  Integrating CMTM with a safety net PCMH was a valuable patient-centered strategy for addressing medication-related problems among homeless individuals. The high acceptance rate of pharmacist recommendations demonstrates the successful integration of pharmacist services.
authors.affiliation: School of Pharmacy, Virginia Commonwealth University, Richmond, VA, USA. lrmoczygemba@vcu.edu
authors.forename: Leticia R
authors.initials: LR
authors.lastname: Moczygemba
authors.forename: Jean-Venable R
authors.initials: JV
authors.lastname: Goode
authors.forename: Sharon B S
authors.initials: SB
authors.lastname: Gatewood
authors.forename: Robert D
authors.initials: RD
authors.lastname: Osborn
authors.forename: Akash J
authors.initials: AJ
authors.lastname: Alexander
authors.forename: Amy K
authors.initials: AK
authors.lastname: Kennedy
authors.forename: Lisa P
authors.initials: LP
authors.lastname: Stevens
authors.forename: Gary R
authors.initials: GR
authors.lastname: Matzke
mesh_terms: D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005500:Follow-Up Studies; D006703:Ill-Housed Persons; D006801:Humans; D054539:Medication Therapy Management / Q000458:organization & administration*; D017146:Models, Organizational; D010342:Patient Acceptance of Health Care; D018802:Patient-Centered Care / Q000458:organization & administration*; D010593:Pharmaceutical Services / Q000458:organization & administration; D010595:Pharmacists / Q000458:organization & administration*; D024382:Professional Role